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Obesity

The media is full of stories highlighting the obesity epidemic that is prevalent across the western world. A diet that is high in processed foods, fats, sugars and therefore calories, combined with a lifestyle that includes little exercise, results in weight gain and this seems to be spiralling out of control.

What is the definition of obesity?

Obesity does not just describe people who weigh in at 20 stones or more. A woman of 5 foot 2 who weighs 12 stone has a BMI that classes her as obese.

BMI stands for Body Mass Index and this measurement is used as a simple way of determining the ratio of body fat to lean tissue. To work out your BMI you divide your weight by your height squared. You can work out your BMI easily using an online BMI calculator. Choose to put in imperial of metric measurements, but do not mix them.

That should give you a number between about 18 and 60:

  • A BMI of lower than 18.5 means you are underweight.
  • A BMI of 18.5 to 25 is the ideal – you are neither underweight nor overweight.
  • A BMI of 25 – 30 indicates you are overweight – this is just by a few pounds but you are still exposing yourself to some health risks.
  • A BMI of over 30 means you are clinically obese and it if is higher than 40, you are morbidly obese.

Why is obesity dangerous?

People who are obese often have issues of low self-esteem and do not like their appearance. But the problems associated with obesity go much deeper. Many serious health conditions are more likely to develop in someone who is obese compared to someone of the same age who is a healthy weight. These health conditions include:

  • Type 2 diabetes – if you have a BMI of 30 you are 10 times more likely to develop diabetes compared to someone with a BMI of 25.
  • Cardiovascular disease – obesity increases the likelihood of developing atherosclerosis, which increases the risk of heart attacks and strokes. High blood pressure is also common in people who are obese.
  • Some cancers – large population studies have shown that obesity is linked with an increased risk of prostate cancer and breast cancer, particularly.
  • Gastro-oesophageal reflux disease (GORD or GERD) – if you are overweight, your stomach is pushed upwards when you lie down, causing acid to be regurgitated into your oesophagus. When this occurs regularly, the mucosa, the layer of tissue lining the lower oesophagus becomes damaged, leading to chronic inflammation.
  • Gallstones – stones that form in the gallbladder. These stones can cause intense pain, inflammation, infection in the form of abscess (empyema) and/or perforation of the gallbladder. This can be a medical emergency. Surgery to remove the gallbladder is then required urgently.
  • Sleep apneoa – the entrance to the airways in the throat have  tendency to close up during sleep in someone who is obese. This stops there breathing for a few seconds, until they become short of oxygen and gasp for breath. Each gasp disrupts the sleep cycle, causing excessive daytime tiredness.
  • Arthritis and joint problems – the weight of the body puts great stress on the skeleton.
  • Hernias – the volume of body fat weakens the body wall, making it more likely that a weak spot will develop that allows the intestines to push through. Hernia repair, like any type of surgery, is more dangerous in someone who is obese.
  • Depression – the reasons are complex, but the body image and health issues, together with increasing disability, can make people very down and anxious.
  • Infertility – men and women who are obese are more at risk of not being able to conceive when they decide to start a family,

Is obesity an epidemic?

The evidence suggests that this might not be an exaggeration. Today, obesity and the health conditions linked with it cost the NHS about £6 billion every year. That figure will increase as the number of people in the UK who are classified as obese rises. Currently its about 25% of all adults over 16 and 16% of children aged 2-16 in England, with slightly higher figures in Scotland.

Tackling obesity

The theory that losing weight is about decreasing the energy you take in through your food while increasing the amount of energy you use up in activity and exercise is simple. Putting it into practice consistently over weeks and months is not simple. Most people find it very difficult indeed.

Support is important and you can find the help you need in different ways:

  • Friends and family
  • A slimming club
  • Your GP and/or dietician
  • Hypnosis
  • A boot camp or supported diet regime

Even so, people can end up putting back the weight they lose, and then gaining more, until their health is at risk.

When should I consider obesity surgery?

If you remain obese despite great efforts to lose weight by diet and exercise, weight loss surgery becomes an option. Different procedures are available, including a gastric balloon, gastric band, a gastric sleeve operation, or gastric bypass surgery.

Deciding to have surgery should not be done without very careful thought and discussion. Mr Alhamdani can explain what each procedure involves and recommend which one will be best for you. He will always explain the alternatives and the potential complications and will stress the long-term changes you will need to make. Surgery is not a way out of taking control of your eating and lifestyle but it can mean you can lose weight and lessen your risk of serious illness.

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